Evaluation of Serum Cystatin C Concentration as a Marker of Renal Function in Liver Cirrhosis Patients

Korean Journal of Nephrology 2008;27(6):650-658.

Ji hyeong Kim, M.D.1, Dong won Shin, M.D.1, Sul hee Yi, M.D.1, Moon han Choi, M.D.1, Jong hyo Choi, M.D.1, Dae yong Kim, M.D.1, Moo yong Park, M.D.1, Soo jeong Choi, M.D.1, Sang gyune Kim, M.D.1, Jin kuk Kim, M.D.1, Young seok Kim, M.D.1, Seung duk Hwang,

Department of Internal Medicine¹
Nuclear Midicine²
and Laboratory Medicine³
Soonchunhyang University College of Medicine, Bucheon, Korea

임상연구 : 간경변 환자의 신기능 평가에서 Cystatin C의 유용성에 대한 연구

김지형1, 신동원1, 이설희1, 최문한1, 최종효1, 김대용1, 박무용1, 최수정1, 김상균1, 김진국1, 김영석1, 황승덕1, 박정미2, 이용하3

순천향대학교 의과대학 내과학교실1, 영상의학과교실2, 진단검사의학교실3

Abstract

Purpose : Cystatin C is known to predict the glomerular filtration rate (GFR) more precisely in patients with substantial muscle atrophy, such as liver cirrhosis, compared to creatinine. We evaluated the usefulness of cystatin C for prediction of renal function in liver cirrhosis patients. Methods : From February 2007 to September 2007, we evaluated the renal function in patients with liver cirrhosis who were admitted to Soonchunhyang University Bucheon Hospital. We compared renal function with GFR as estimated by creatinine (Modification of diet in renal diseases; MDRD, the Cockroft&Gault equation; C&G, Creatinine clearance; CCr) and cystatin C (the Hoek and Larsson equations) with that of the GFR as calculated by Cr-EDTA. Results : A total of 46 patients were enrolled. The mean GFR was 67.8±29.4, 81.6±29.6, 79.9±29.3, 62.7±29.8, 77.0±28.6, 81.0±35.2 mL/min/1.73m2 according to Cr-EDTA, MDRD, C&G, CCr, Hoek and Larsson equations, respectively. Cystatin C showed a correlation to MDRD (r=-0.715), C&G (r=-0.659), CCr (r=-0.536) and Cr-EDTA GFR (r=-0.617). GFR by the Hoek (r=0.657) and the Larsson (r=0.647) equation using cystatin C showed a higher correlation with Cr-EDTA GFR than GFR by MDRD (r=0.550) and C&G equation (r=0.458). Conclusion : Cystatin C is a more accurate predictor of renal function than creatinine in patients with liver cirrhosis.

Key Words: Cystatin C, Liver cirrhosis, Glomerular filtration rate